Billing Funding Bodies and Third Parties
You can easily bill and send invoices to funding bodies and other third parties who pay for patient treatment. For example, you can invoice a school for treatment that you provide to a student (a third party invoice) and you can invoice a workers compensation program (a funding body) for treatment provided to a worker injured at work who is eligible for treatment covered by the workers compensation program.
You add fees, appointments and invoices covered by third parties and funding bodies in a very similar way to when you add fees, appointments and invoices paid for by patients, with some minor and important differences that enable you to get the most out of your HealthKit software.
Watch this mini-video to see third party billing in practice.
- 1 Adding Fees to bill third parties and funding bodies
- 2 Invoicing a third party or funding organisation
- 3 Recording payment of a third party invoice
- 4 Videos
Adding Fees to bill third parties and funding bodies
Just like you can add a fee for patient treatment to your Fee List from your calendar, an invoice or directly on your Fee List, you can also add a third party fee (i.e. a fee paid by a third party such as a school or compensation program for treatment of a student or injured worker) in the same three ways:
- From the Calendar: start typing the name of the fee in the Fees Field, and select that you would like to add it as a new fee;
- On an invoice: click the Add Fee or Add Another Fee button; or
- From the Fee List: click the Add Fee button at the top right of the screen.
Enter the fee information in the same way that you enter non-third party fees. There are only two areas where fees for third parties and other fees differ:
- Funder Type: Either enter the name of the funding body or select Third Party as the funder type if it is a third party that is paying for the treatment. Selecting either of these options as the funder ensures that the correct claim details are specified on your invoices. For example, if you provide services to schools, enter "School services" as the funder, so that the fee applies no matter to which specific school you provide the services.
- Amount and rebate: The rebate amount is the amount that the third party or funding body pays, and so the rebate should be above $0 for third party fees. The rebate and the amount fields should be the same if the patient pays nothing above what the third party or funding body pays. The amount field should be higher than the rebate fee if the patient pays a gap or surcharge above what the third party or funding body pays, because the amount is the rebate plus any surcharge.
|You can set the rebate when you add your fee. As the rebate amount is the amount that the third party pays, it should (in most circumstances) be the same as the fee amount.|
Entering the fee name, item number (if any), duration (if the fee is for an appointment), fee type and category, and selecting the fee colour is the same for third party and other fees.
Invoicing a third party or funding organisation
Creating an invoice
Because a third party invoice is an invoice for a patient's treatment paid for by a third party (e.g. a student's treatment paid for by a school), you create a third party invoice in the same way that you create an invoice for a patient's treatment. Select a third party fee as the fee when you create an invoice, which you can do in one of three ways:
- From an appointment: Whenever you make a patient appointment an invoice is automatically created - simply choose a third party fee as the fee;
- From your Invoices List: create a manual invoice (for an appointment or a non-appointment) by going to your Invoices List and clicking the New Invoice button at the top right of the screen, then select a third party fee as the fee; and
- From an organisation's profile: select the organisation from the Organisation List and click New Invoice button on the organisation's profile and select a third party fee as the fee.
Adding the paying organisation and any referral details
Add the name of the funding body or third party that is paying for the treatment by clicking the Edit icon on the calendar, and entering the name of the third party organisation or funding body in the Paying Organisation field. If the organisation is on your Organisation List, select it as the paying organisation. If the organisation is on HealthKit's organisation database (which is the case mainly for funding bodies), it is shown in grey, and you can select it to make it the paying organisation and at the same time import the organisation into your Organisation List. If the organisation is not on your Organisation List or the organisation database, enter the details of the organisation, and the organisation is added to your Organisation List and as the paying organisation.
If you make an appointment with this patient using the third party fee again, the organisation you have entered as the paying organisation is automatically selected for you as the paying organisation again.
If required, you can add referral details, by clicking the Add Referral button. Enter the details of the referral including referrer and any appointment or time limits to the referral, just as you do for other appointments and invoices (click here for more information).
Third parties that pay for a patient's treatment are listed on the patient's Funding page.
Billing the paying organisation
HealthKit uniquely enables you to handle any funding body or third party's billing requirements, no matter whether the organisation requires one invoice for each patient or whether it allows multiple patients' fees on the one invoice.
To bill an organisation for the patient's treatment, access the invoice for the appointment (from the calendar, the Invoices List, the patient's History page or the organisation's profile), and click the Invoice Funder button in the Payments section of the invoice, and confirm that you want to bill the paying organisation (which means that the patient does not pay). After you have clicked the Invoice Funder button, you can:
- Add this fee to an existing unpaid invoice with multiple patients for this paying organisation (if more than one patient's fees are listed on the invoice, hover over hyperlink under patients to see which patients are listed);
- Add this fee to an existing unpaid invoice for this patient for this paying organisation;
- Create a new invoice for this patient for this paying organisation; or
- Change the payer on the invoice to the paying organisation.
The relevant invoice for the paying organisation is created or updated with this patient's fees. The patient's full claim and referral information are shown on the printed invoice (you can hover over the patient's name to see their claim and referral details). You can click on the date next to the patient's name in the Fees & Charges section of the invoice to view the original patient invoice.
Recording payment of a third party invoice
When the third party paying organisation or funding body pays the invoice, go to the Invoice and click the Mark as Paid button. Select the payment method and click Enter, just as you would for an ordinary patient invoice, and the third party invoice status is changed to be Fully Paid. If the organisation pays less than the amount that you billed them, record the amount that was paid and the invoice status is marked as Partially Paid. You can recoup the difference from the patient, or change the fee on the third party invoice to the amount that was paid, in which case the invoice status is changed to Fully Paid.
How do I invoice third parties for patient appointments, reports and assessments?
You create appointments and invoices for third party funding bodies (such as WorkCover and other compensation schemes) in a similar way to creating patient-direct invoices and Medicare invoices. Watch this video to see third party invoicing in action.
How do I create an invoice schedule?
You can set a regular invoice schedule, for patients with claim details for third parties, so that the charges with the same funding body can be grouped together.
Why are some of my invoices showing as partially paid and at the same time, creating two invoices?
This can occur for two reasons: The payer is set as organisation and the rebate field has been set as different from the total field. To correct this, open the invoice billed to the organisation, click Cancel and select “Revert the fee back to the patient”. Then click the Invoice Summary cog wheel, and from the Payer drop down menu, select Organisation.